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目的:探讨多巴胺联合食管心房调搏负荷试验(TEAP)在诊断冠心病的准确性。方法:选取30例有胸痛或胸闷症状临床怀疑心绞痛但常规心电图无明显心肌缺血表现者,先行TEAP,30min后静脉使用多巴胺10μg/(kg.min),当血压达到稳定后,再次行TEAP。记录先后两次负荷试验结果,以冠状动脉造影结果作为诊断冠心病标准(冠脉狭窄≥50%为阳性,诊断冠心病;<50%为阴性,诊断非冠心病)。比较两种负荷试验方法的敏感性及特异性。结果:TEAP敏感性为57.1%,特异性为77.8%;多巴胺联合TEAP敏感性为81.0%,特异性为88.9%。联合负荷试验敏感性高于TEAP(P<0.05),两组特异性无统计学差异(P>0.05)。结论:与常规的TEAP比较,多巴胺联合TEAP能提高诊断冠心病的敏感性,不降低特异性,可作为诊断冠心病的有效方法。
Objective: To investigate the diagnostic accuracy of dopamine combined esophageal atrial pacing load test (TEAP) in patients with coronary heart disease. Methods: Thirty patients with angina pectoris or chest tightness who were suspected of having angina pectoris but who had no obvious myocardial ischemia in conventional electrocardiogram were enrolled in this study. TEAP was given first and dopamine 10μg / (kg.min) intravenously 30 minutes later. When the blood pressure was stabilized, TEAP was performed again. Record twice the load test results to coronary angiography as a diagnostic standard for coronary heart disease (coronary stenosis ≥ 50% positive diagnosis of coronary heart disease; <50% negative diagnosis of non-coronary heart disease). Compare the sensitivity and specificity of the two load test methods. Results: The sensitivity and specificity of TEAP were 57.1% and 77.8%, respectively. The sensitivity and specificity of dopamine combined with TEAP were 81.0% and 88.9%, respectively. The sensitivity of combined load test was higher than that of TEAP (P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusion: Compared with conventional TEAP, dopamine combined with TEAP can improve the sensitivity of diagnosis of coronary heart disease without reducing the specificity, which can be used as an effective method to diagnose coronary heart disease.